JP2008523935A - Dental implant - Google Patents

Abstract

An anchor part for fixing the dental implant to the bone and an abutment for fixing the superstructure are provided. The abutment is connected to the anchor part, and the anchor part and the abutment are made of zirconium oxide. A dental implant is proposed. In this dental implant, the central axis extends in the same direction and is integrally connected to each other at the upper end so as to form an abutment and is inserted into corresponding holes in the jawbone and can be inserted into corresponding holes. Propose to equip the body with anchors.
[Selection] Figure 1

Description

  The present invention relates to a dental implant according to the preamble of claim 1 and to a method for manufacturing a dental implant.

  Various types of dental implant embodiments are known. Dental implants are used to receive superstructures such as bridges and crowns. A dental implant of this type is known, for example, from German Offenlegungsschrift 10,159,683, which is made of zirconia ceramic.

  Conventionally, when several teeth are replaced, a plurality of dental implants are used correspondingly. This is not only expensive, but the available space in the jawbone is adequate to receive multiple implants of this type, especially as a result of contraction, for example due to the relatively long gaps. It can happen that it is not. Furthermore, the stability of individual implants is not sufficient, especially if there is a problem with the bone condition.

  The object of the present invention is to provide a dental implant and a method for producing and / or positioning said dental implant, suitable for ensuring high strength while being simple to manufacture and use and process. Disclosed is a jig for inserting and a pushing support tool.

  In order to achieve this object, the dental implant according to claim 1, the jig for inserting the dental implant according to claim 13 or 14, or a pushing support tool, and the method for producing the dental implant according to claim 17, Item 20. A method for manufacturing and positioning a dental implant according to Item 21 is provided.

  In particular, to achieve this object, an anchor part for fixing a dental implant to a bone and an abutment for fixing a superstructure connected to the anchor part are provided, and the anchor part and the abutment are zirconia. In a dental implant for a patient made of ceramic, the anchor part comprises at least two substantially cylindrical bodies whose central axes extend in the same direction, the body being the upper end so as to form an abutment A dental implant is provided that is integrally connected to each other and can be inserted into corresponding holes in the jawbone.

  Finally, the two cylindrical bodies that are integrally connected to each other extend in the same direction, so that the dental implant can be pushed into the hole in the jaw. The elasticity of this dental implant is substantially greater than the total strength of the individual dental implant, because the connection between the two cylindrical bodies acts as a working lever, so that the bending moment is absorbed very beneficially. This applies to loads in almost all directions and at all points on the masticatory surface except for each individual point located directly on the respective central axis of the cylindrical body.

  In principle, dental implants can also be used to reconstruct a single tooth. However, two teeth located next to each other, or in particular three teeth, are replaced with dental implants, after which the abutment is configured to form a bridge for the three prosthetic elements Is preferred. This greatly reduces the cost of replacing several teeth.

  The abutment preferably has a pontic structure between the anchor parts. As a result, the cost for making the bridge is greatly reduced. In this type of pontic structure, the part of the structure located below the connection between the anchor parts is polished and preferably oval so that this part on or adjacent to the gum is simultaneously under the superstructure. Side portions may be formed. In this case, zirconium ceramic is also preferably dyed so as to correspond to the superstructure.

  The superstructure can be attached (bonded or joined) to the dental implant in a known manner. In a preferred embodiment of the invention, before the dental implant is inserted, the superstructure, in particular the bridge, is fixed to the abutment and in particular is melted onto the abutment. This not only allows for a more secure connection between the dental implant and the superstructure, but also significantly reduces the number of work steps.

  In a developed version of this embodiment, the superstructure only has a front lip. The abutment at the rear is in particular accessible from above and can be taken into the jaw or pushed in without applying a load to the superstructure.

  In another form, the superstructure secured to the abutment is provided with an opening such that the abutment is particularly accessible from above. This makes it easy to insert or push the dental implant into the hole without damaging the superstructure. After positioning the implant, an invisible part (for example, a part away from the lip side of the tooth) can be easily attached, and this advantage can be used without affecting the cost and work quality. In addition, the chewing surface is generally adapted or generated after insertion of the implant. This can be done without additional costs associated with sealing the opening.

  Even if it is desirable to relax or protect the newly positioned implant, only partial generation of the superstructure secured to the abutment is obtained. The temporary structure can be attached to the superstructure in such a way that the closure surface of the superstructure is located below the mastication surface of the adjacent tooth and no load is applied during mastication. After a given healing time of the dental implant, this temporary part is replaced with a fully functional final part. In other forms, removable thin protective rails can be attached to the superstructure and adjacent teeth to remove the dental implant and removed after a given period of time.

  The implant has at least one support structure for holding and / or pushing the cylindrical body in the hole. Thereby, the specified pushing point can be determined for insertion, and the support tool can be attached.

  The cylindrical body preferably has a rough surface over a substantial portion of its outer surface that significantly enhances the growth penetration or connection with the jawbone in a known manner. This rough surface is preferably formed before final sintering of the corresponding base element of the dental implant by sandblasting or similar cutting deformation, which greatly simplifies the manufacture of the dental implant. The

  The dental implant is preferably provided with a protective layer that can be removed immediately before insertion so that bacteria do not enter the jawbone at least in the region of the cylindrical body. This type of protective layer may be configured for machine removal.

  In order to achieve the above-mentioned object, at least two holding elements for adjusting the jig on an auxiliary implant integrally connected to at least one tooth or jaw and two central axes extending in the same direction are also provided. There is provided a jig for inserting a dental implant as described above having a hole and through which the drill can be guided in a controlled manner to form a hole in the jawbone. With this type of jig, the hole for receiving the cylindrical body of the dental implant corresponds exactly to the implant.

  The dental implant can in particular be brought to the secure attachment position of the jaw in a simple manner using a pushing aid. The push aid includes a body having a receiving opening and a receiving seat, the receiving opening being formed to receive at least a portion of the abutment, wherein the receiving seat is one of the anchor parts of the abutment inserted into the receiving opening. It is preferable that the central axis is disposed on the main body of the push-in support tool so that the central axis is substantially perpendicular to the seat. As described above, the pushing support tool is attached to the anchor part and the abutment, and the anchor part can be pushed into the jawbone by giving an application point. Since the abutment may be at a relatively large angle with respect to the central axis of the anchor part, the push aid assists in applying a force along the central axis and thus along the push direction. The seat provides in this case the required work surface.

  The pushing support tool is preferably formed from a plastic material.

  The receiving opening of the pushing aid does not have to completely surround the abutment. Since the upper end engages with the receiving opening, it is often sufficient to maintain a reliable attachment of the pushing assist tool.

Furthermore, in order to achieve the above purpose,
Creating a three-dimensional digital image in the area of the patient's jawbone and gums into which the dental implant is to be inserted;
-Generating a digital representation of the dental implant;
Milling the zirconium oxide-based base element, if necessary, to compensate for shrinkage;
-Sandblasting the cylindrical body of the base element;
A method of manufacturing a dental implant, in particular a dental implant of the type described above, comprising the step of burning / sintering the machined base element.

  The aforementioned jig is also manufactured according to a three-dimensional digital image or a digital representation of a dental implant. For this purpose, both the implant and the jig can be substantially manufactured using a digitally controlled machine to pass the corresponding data record and the impression of the teeth adjacent to the implant to the dental technician. .

  Preferably, a pontic structure between the anchor parts having an oval structure is provided on the bridge portion of the dental implant so as to form a lower end for the superstructure, the oval structure being a combustion / Since polishing is performed before and / or after sintering, labor saving is achieved and the final result is improved.

  The oval structure is preferably dyed to correspond to the color of the superstructure, thereby improving the appearance.

  In a preferred embodiment of the invention, after burning / sintering of the implant, the superstructure is at least partially attached, in particular bonded or melted, so that a dental implant with a “semi-finished” superstructure is obtained. Made. It is also possible to completely make a dental implant consisting of an abutment with anchor parts and an attached superstructure. In this case, care must be taken during positioning of the dental implant, in particular during hammering, so as to avoid damage to the superstructure. However, testing has shown that a finished dental implant with a protective coating can be inserted if there is a corresponding hole in the jawbone without damaging the superstructure or another part of the dental implant. . The protective coating can be, for example, a removable plastic material coating.

  Finally, the present invention has at least one cylindrical anchor part for fixing the hole corresponding to the jawbone and has a hammer head for applying an impact load to the dental implant, in particular the cylindrical anchor part. And a dental implant fixation tool having drive means for driving the hammerhead with a pre-adjusted defined impact load over a pre-adjustable distance. Thus, the doctor inserting the dental implant need not rely solely on his own sense of pushing the implant. In addition, reproducible working conditions can be created.

Furthermore, in order to achieve the object of the present invention, in a method for manufacturing and positioning a dental implant,
Generating a three-dimensional digital model of the anatomy of the region adjacent to the prospective location of the dental implant, in particular the region of the teeth, jawbone and gums;
-At least partially computer-aided design of dental implants individually adaptable to the anatomy;
-Producing a dental implant;
A method of manufacturing and positioning a dental implant, in particular a dental implant of the type described above, comprising the steps of validating and documenting the work performed.

  A particular advantage of this method is that the computer-aided design of dental implants individually adapted to the patient's anatomy can be based on a three-dimensional digital model of the anatomy, so that the dental implant and patient Preoperative matching between the anatomical structures can be optimized.

  The method preferably includes positioning a dental implant.

  In this method, one of the other steps necessary to manufacture and position the implant is preferably performed using a computer. For example, the production process can be optimized by computer-operating a milling unit, drill, or sandblasting nozzle. Production costs are reduced by savings in terms of labor costs and low material wear, in other words, the accuracy with respect to production errors is improved and the time required is minimized. A computer can also be used to perform motion engagement more efficiently. In this way, a computer equipped with a corresponding input / output device can assist a doctor during surgery. Due to the increasing importance of documentation and validation in medical work, dentists and / or dental technicians can store implant and / or model data and / or various operational and / or production parameters. And / or increase the transparency of other parties. For example, comparing the actual location of the implant with the planned location, or cataloging selected operational and / or production parameters related to the quality of work performed (eg, the useful life of the implant, cosmetic effects, etc.), and It is possible to increase.

  To obtain a three-dimensional digital model of the anatomy of the region adjacent to the prospective location of the dental implant, for example, CT (Computer Tomography), MRT (Magnetic Resonance Tomography), Medical US (Ultrasound Therapy) Almost all conventional imaging methods in human medicine are conceivable. However, it is preferred to utilize a specific CT method, DVT (Digital Volume Tomography), because the corresponding device for generating the model provides sufficient data to make bones and teeth efficient and It can be mentioned that it is imaged with high accuracy and exists in most dental clinics.

  Software programs (eg, CAD software) that develop three-dimensional components with computer assistance have long been known in the art. The quality of dental implants is improved by designing individual parts of the superstructure, abutment, and anchor part with a computer using corresponding 3D digital models of adjacent anatomical structures . CAD software adapted for dentists and / or dental technicians can be used to design a patient-specific dental implant that is optimally adapted to the patient and the patient's medical history. For example, it is not necessary to adapt the dental implant after insertion, such as fine adjustment of the abutment in the mouth.

  The software preferably provides a predefined set of components and / or configurations. In this way, a highly suitable raw model of a dental implant that requires minimal modification to obtain an optimal fit is provided for each application (eg, number of teeth to replace, implant location). In this way, the denture design is optimally simple for the dentist and / or dental technician.

  One possibility for individually adapting dental implants comprising superstructures, abutments and anchor parts adapts the configuration, in particular the number of prosthetic elements received and / or the diameter of the abutment It is in.

  Further adaptable parameters of dental implant production or design include the height and shape of the abutment and the height and shape of the anchor part.

  A further possibility for adapting dental implants is the abutment and anchor so that the angle between the hole axis given to the anchor part and the horizontal axis of the superstructure can be freely selected. To adapt the parts.

  Preferably, the length and / or diameter and / or color of the superstructure is adaptable in the computer aided design of the dental implant. The length and diameter of the superstructure are important factors in the function and service life of the dental implant, and the diameter and color determine the appearance of the denture.

  If the at least partial computer-aided design includes computer-aided planning of the location of the dental implant, the design can be adapted to the adjacent anatomy with high accuracy. Furthermore, implant positioning can be planned pre-operatively.

  Automatically, the drill rail can be generated at the planned location, initially as a three-dimensional model and then as an actual drilling tool for inserting a dental implant. The drill rail makes it easier to find the location, the exact drilling angle, and the exact planned drilling depth during drilling.

  If the computer further provides device navigation (ie, the position of the equipment used relative to the patient's position can be determined during the operation), the computer will, like a car navigation system, the optimal preoperative plan for the dental implant by the physician. It can make it easier to find the location. The computer may also perform a portion of device operation during surgery (eg, the rotational speed of the drill) using appropriate input / output devices.

  Preferably, the production of the dental implant includes computer assisted generation of a cap for receiving the superstructure. Traditionally, during the manufacture of fixed dental implants, the impression of a previously fixed dental implant is created after the artificial root is installed, ie when the anchor part and abutment are incorporated into the jawbone. This impression is used to make a cap that fits exactly to the abutment. This cap forms the carrier for future superstructures or crowns. Conventionally, a powder / liquid mixture is applied to the cap and burned in a furnace to form a ceramic. The ceramic substantially forms the visible portion of the denture. Pre-fabrication of the cap ensures reliable conformation of the superstructure, for example, due to saliva, blood, inaccurate preparation limits, dimensional changes in impression during transport from dentist to lab, etc. Thus, errors that normally occur during imprinting in the mouth are avoided.

  Preferably, computer aided design of the dental implant includes computer aided design of the abutment, and computer aided generation of the cap comprises computer aided calculation of the internal structure of the cap, wherein the cap is abuted. Can be attached to the In this way, a suitable cap for subsequent receipt of the superstructure can be designed or made as early as the planning stage or during the design of the dental implant. Data on the dimensions of the abutment for the design of the dental implant can be obtained, making it easy to calculate an accurately matching cap. Impression production is no longer necessary.

  Even if the cap is not made in a computer-aided way, it is possible to make the cap in the dental technician's lab, because there is no need to adapt individually made dental implants in the field, ie in the patient's mouth It is.

  The calculation of the internal structure preferably takes into account the incorporation of adhesive to secure the cap to the abutment. Other variables, such as the degree of shrinkage of the material used, can also affect the calculation.

  It would be beneficial if computer-aided generation of caps included computer-controlled milling of the cap or cap model. In this way, a computer generated model of the cap can be realized relatively inexpensively. For this purpose, the cap can be milled immediately using a milling unit, or a model can be produced that continues to form the basis for manufacturing the cap. Similarly, a cap mold may be generated by a computer-aided method.

  The positioning of the dental implant preferably includes the production of a push aid for the dental implant so that the dentist can easily insert or push the pushable dental implant. Of great importance in this regard, ensuring that the push aid fits into the dental implant prevents both sliding of the dental implant and damage to the dental implant.

  If the dental implant comprises an abutment and an anchor part connected to the abutment to secure the dental implant to the jawbone, the push aid for receiving at least a portion of the abutment in the production of the push aid It would be beneficial to include the formation of a receiving opening above. In this way, the push aid can accept this part with precise fit and establish a positive contact with the abutment.

  Since the production of the push aid includes computer aided calculation of the receiving opening, it is preferred that the push aid is attachable to the abutment. Preferably, the computer-aided design of the abutment's dental implant provides accurate data regarding the shape and surface structure of the abutment so that the receiving opening can be configured to securely secure the push aid to the abutment. Is possible.

  Preferably, the production of the push-in support tool includes computer-aided determination of at least one central axis of the anchor part and computer-aided formation of the seat on the push-up support tool, the seat being centered on the center axis. Ideally it should be vertical. By determining the center axis of the anchor part substantially the same as the direction in which the dental implant is pushed, the force applied through the seat is transmitted to the dental implant in such a way that a simple pushing is possible. In this way, it is possible to configure a pushing support tool adapted to a dental implant.

  The production of the push-in support device is a tool for the push-in support device or the push-in support device so as to facilitate the production of the push-in support device itself or the production of a model or impression of the push-in support device that continues to act as the basis for generating the push-in support device. It preferably includes computer controlled milling of the model.

  Preferred embodiments of the invention emerge from the dependent claims.

  Hereinafter, embodiments of the present invention will be described in more detail with reference to the drawings.

  In the following description, the same reference numerals are used for identical and equivalent parts.

  As shown in FIG. 1, an embodiment of the present invention of an implant 10 forms two anchoring bodies 12, 13 'that form anchor parts 12 and are inserted into corresponding cylindrical holes in the jawbone (pressed from above). Is provided. These cylindrical main bodies 13 and 13 ′ are connected at the upper end (14, 14 ′) of the main body via the abutment 11 to form an integrated main body.

  Since the pontic structure 15 is provided between the two cylindrical bodies 13 and 13 ', the bridge can be attached as a superstructure.

  The pontic structure 15 may have a polished portion 16 which is visually not a superstructure at its lower end facing the gums, but is a component thereof.

  Since the implant 10 is preferably given according to the color of the final superstructure 20 as a whole, the transition between the superstructure 20 and the abutment 11 is hardly visible.

  To produce the implant 10, the digital data (the derivation of which is described below), the shape corresponding to that described in FIG. 1, and, if necessary, the base element are transferred to a strong resistant final microstructure. Therefore, after firing / sintering of the base element, there is a milling from a zirconium oxide based blank or base element that can be machined very easily according to the excess that the final dimensions are achieved.

  Furthermore, the anchor part 12 is roughened at a point intended to fuse with the bone prior to combustion / sintering, for example by sandblasting or similar processing techniques known in the art. This roughening is carried out very easily on the base element, whereas fully burned / sintered ones can only be machined with very high effort.

  Once manufactured in the manner described above, the implant 10 can be sterilized and packaged for delivery to the treating physician. After sterilization, for example by mechanical extraction, at least the relevant part of the implant 10 to be inserted into the bone is coated with a protective layer 17 which is removed immediately before insertion. This ensures a high degree of sterilization.

  The difference between the embodiment of the invention shown in FIG. 2 and that shown in FIG. 1 is that a dental implant 10 forms an anchor part 12 with two other cylindrical bodies 13, 13 ′. The main body 13 ″ is provided. The third cylindrical body 13 ″ is centrally located between the other two cylindrical bodies 13 ″ and provides further stability during positioning of the dental implant 10.

  A further embodiment according to the invention of a dental implant that can be pushed in may be inferred from FIG. In this way, it is possible to fix four or more crown superstructures 20 to an anchor part having three cylindrical bodies 13, 13 ', 13' '. FIG. 12 is a plan view of three dental implants 10 according to the present invention secured to the jawbone 90. The two outer dental implants 10 in this case receive superstructures 20 with three respective crowns. The abutments 11 of these two dental implants are of similar construction to the abutment 11 of FIG. The third central dental implant 10 has a superstructure 20 capable of receiving six schematically shown crowns. The associated abutment 11 has a slightly U-shaped shape curved in the plane along the central axis (not shown) of the anchor part based on the arrangement of the anterior incisors. As shown in FIG. 12, it is clear from the exemplary full prosthesis that there are numerous possibilities for the configuration according to the invention of the pushable dental implant 10.

  FIG. 3 is a cross-sectional view of the implant 10 shown in FIG. 2, but with the superstructure 20 attached. In this embodiment, the superstructure has a two-part configuration, and the fixed portion 21 of the superstructure 20 that surrounds the abutment 11 is completely configured in the lip portion. And the remaining parts of the superstructure 20 are in the form of temporary portions 22. The temporary portion 22 is only secured to the dental implant 10 when the implant is positioned. Thus, during positioning of the dental implant 10, the opening 30 remains, and a force can be applied to the abutment 11 through the opening without damaging the superstructure 20. This and the ability to hold the dental implant via a push pin (not shown) located in the opening 30 facilitates insertion, particularly hammering, and protects the superstructure 20. Thus, in general, the opening 30 can be used not only as an access to the abutment 11 but also as a support for improving implant insertion.

  With the temporary portion 22 down (or polished down), the forces acting on the new implant during the treatment phase (eg, caused by bruxism or chewing) can be substantially reduced.

  In other forms, the abutment 11 can be attached to the abutment 11 before insertion, after which the abutment is inserted into the jaw as a component. A protective cap can also be provided to protect the dental implant during pushing.

  FIG. 7 shows yet another form for inserting an abutment 11 having an anchor part 12. The superstructure is in this case preferably not attached or attached to a lesser extent before it is inserted into the jaw. Insertion is supported by a push aid 70 produced individually for each dental implant. This push aid 70 is configured to form an adapter between the abutment 11 and the driving tool (see the hammer schematically shown in FIG. 7). The important function of the driving aid is that the applied force is transmitted to the abutment 11 and the anchor part 12 and is exactly parallel to the central axes X, X ′ of the anchor part 12 (see FIGS. 1 and 2). It is to act on. For this purpose, the pushing support tool 70 includes a main body 71, and the receiving openings 73 are milled from the main body 71 so that the respective abutments 11 are securely positioned in the receiving openings 73. A seat 72 formed substantially on the main body 71 is located on the side of the main body 71 away from the receiving opening 73 so as to provide a surface perpendicular to the central axes X and X '. The pushing aid is particularly useful in the embodiment of the abutment 11 according to the invention shown in FIG. 7, since in this embodiment the axis Y of the abutment is not parallel to the central axes X, X ′. This is because it is difficult to apply a pushing force to the abutment 11 that is significantly inclined with respect to the axes X and X ′.

  In order to define the shape of the implant, first a data record for deriving at least the jaw structure of the region into which the implant is inserted is obtained in a known manner using the CT / DVT method. Known software processes are used to further define the basic shape of the implant that is subsequently inserted into the bone. In this way, it is possible in particular to optimize the strength of the jawbone, especially by changing the shape of the implant of the cylindrical bodies 13, 13 'and positioning it accordingly. It is also clear that the structure and location of adjacent teeth and gums plays an important part, especially in the shaping of the abutment implant.

  Also, an impression of the tooth next to the region into which the implant is inserted is made, and its basic structure is shown in FIG. 4, from which the jig 40 can be made. This impression is also inserted and used to obtain a plaster model 44 having a dental model 42, 42 'that is an exact replica of the patient's corresponding tooth. In this way, the jig 40 has retaining elements 41, 41 'formed as recesses that fit exactly through the teeth adjacent to the implant. In this way, the position of the jig 40 relative to the patient's jaw structure is defined.

  In a subsequent step, holes 43 and 43 'are formed in the jig 40 based on the digitized data so as to correspond to the cylindrical bodies 13 and 13'. Since the jig 40 defines the position of the jig 40 relative to the jaw, the same applies to the holes 43 and 43 '. Since the holes 43 and 43 'are equipped with sleeves by a known method, it is possible to make holes in advance or to make holes by adjusting them individually.

  A manually actuated tool can also be used to push the implant. However, because the space conditions are very limited, it is beneficial to utilize a tool that operates with an external power source. This type of tool will be described with reference to FIG.

  The tool 50 has a hammerhead 52 having a substantially spherical or spherical / semispherical striking surface 54 at least in the portion into which the implant 10 is pushed. Surprisingly, it has been found that this type of curved surface provides a very accurate workpiece. It is clear that the striking surface 54 can be designed to have a parabolic curvature, for example, rather than an exact spherical shape. The hammer head 52 is fixed to the end portion of the stem 53 attached to the handle 57 so as to be rotatable around the rotation shaft 55.

  To move the assembly, a drive 56 configured in the embodiment of the present invention as a pneumatic drive is provided. A pulse sensor 61 for measuring the pulses applied to the implant 10 by the hammerhead 52 is provided.

  Also, since the handle 57 is provided with an adjusting device 58 for adjusting the distance covered by the hammer head 52, the hammer head covers the same distance each time the actuator 59 is actuated.

  Electric power (pressure) for the pneumatic drive 56 is supplied via a controller 51 that supplies pressure from the compressed air source 60. An adjusting member 62 for adjusting the impact load is provided. A pulse display 63 for displaying the pulse energy is provided.

  In this regard, it should be noted that the tool can have different drives or different suspensions that determine the movement of the hammerhead 57. However, it is important to use a reproducible impact load.

  In the following, a method according to the invention for manufacturing and positioning a dental implant will be described. In selected embodiments, the dental implant is a dental implant that can be pushed into the jawbone as described above with reference to each of FIGS. 1-3 and 7. However, the illustrated method is also suitable for the production of other dental implants, such as fixed dental implants that are screwed into the jaw and removable prosthetic parts such as dentures.

  To enhance the understanding of the method according to the present invention, several important features for accurately positioning the dental implant in the jawbone will be described with reference to the cross-sectional view of FIG. FIG. 6 shows an anchor part 12 formed integrally with the abutment 11 as shown in FIGS. The superstructure 20 is provided at a position on the abutment 11. The anchor part 12 is pushed into the jawbone 90. In order to optimally fit the anchor part 12 to the jawbone 90, the central axis X, X ′ (see also FIG. 1) of the anatomical structure of the jawbone 90 is positioned as centrally as possible in the jawbone quality. It is important to adapt, i.e. to stretch. On the other hand, the abutment axis Y is important for the orientation of the superstructure 20 and thus for its function and appearance. The abutment axis substantially controls the orientation of the superstructure relative to the adjacent teeth. Therefore, in the case of a functional dental implant, it is important that both the central axis X, X 'and the abutment axis Y are selected to best fit the respective conditions. Due to this fact, it can happen that the axes X, X 'and Y do not coincide with each other but form an angle with respect to each other as shown in FIG.

  A further important feature of the dental implant of FIG. The effect of this cap on the function of the dental implant is only indirect, but is crucial to the production process. In many cases, the superstructure 20 is produced separately from the abutment 11 and the anchor part 12. For example, the superstructure 20 is produced in a casting process where the mold or impression is filled with a powder / liquid mixture. In order to ensure conformity of the superstructure 20 to the abutment 11, the cap 80 is pre-produced to optimally fit the abutment 11 and then introduced into the powder / liquid mixture that subsequently forms the superstructure. Is done. Separate production steps can be inferred from FIGS. 11a and 11b. Figures 8a-8c further illustrate this fact. FIG. 8a shows a further embodiment of a dental implant according to the invention similar to that of FIG. The anchor part 12 includes a first cylindrical body 13 and a second cylindrical body 13 '. The cylindrical body is introduced into the jawbone 90. The abutment 11 having a shape integral with the anchor part 12 forms a bridge structure between two cylindrical bodies 13 and 13 ′ having central axes X and X ′ along the longitudinal direction of the cylindrical bodies 13 and 13 ′. . A superstructure 20 (see FIG. 8 b) conventionally joined to the abutment 11 can be attached to the abutment 11. In order to produce the superstructure 20 to fit exactly with the abutment 11, the cap 80 forms part of the superstructure. An important factor for ensuring conformity of the superstructure 20 or cap 80 is the cap internal structure 82 (see FIG. 8c), which is based on the inverse structure of the upper portion of the abutment 11.

  Unlike FIG. 8a, FIG. 9a shows an abutment 11 having an anchor part 12 together with a dental implant, a so-called superstructure 20 that can accept two crowns instead of three crowns. The superstructure 20 and the cap 80 differ accordingly (see FIGS. 9b and 9c).

In the following, referring to the method according to the invention for manufacturing and positioning a dental implant, this method consists of five main steps:
Generating a three-dimensional digital model of the area adjacent to the prospective location of the dental implant;
-Computer aided design of dental implants individually adapted to the anatomy;
-Producing a dental implant;
-Positioning the dental implant;
-Enabling and documenting the work performed;
Have

  As described above, conventional human medical imaging methods are used to generate a three-dimensional digital model. Examples of such methods include ultrasound, CT, MRT methods, and laser scanning. Software created specifically for this method can be used to represent digital models of the most important anatomical structures such as teeth and jawbones. Individually adapted dentures are designed based on this digital model. The software provides various pre-produced components for generating the raw structure of the dental implant. Thus, for example, in the first step, it can be selected whether the denture is for one tooth or several adjacent teeth. A predetermined anchor part can then be selected that matches the jawbone structure as close as possible and is suitable for holding the selected dental implant. The shape of the anchor part can subsequently be optimally adapted to the respective anatomy, for example by “drag and drop” or digital input. Individually adapting the anchor parts is particularly useful when osteoporosis or any other reason causes little or no bone quality. Then, as shown in FIG. 10, the anchor part 11 can be adapted to be optimally adapted to the jawbone 90 and the gum 91. It can be done without complex artificial structures of bone quality.

  The predetermined abutment can be selected either simultaneously with the anchor part or afterwards. Abutments can also be adapted to individual anatomical structures by the techniques described above. In this case, in particular, the angle between the anchor part 12 and the abutment axis Y (see FIG. 6) is extremely important in order to ensure that the dental implant is fitted.

  During the design of the dental implant, the software allows the location of the dental implant fit in the anatomy to be planned simultaneously, particularly in the jawbone. This position can also be accommodated by “drag and drop” or digital input. The software provides multiple views that are appropriate to continue to enable work. Once the design and fit are met, software enhancements can continue to generate drill rails that indicate positions in the jaw that require pre-drilling to position the dental implant while inserting the dental implant . It is also envisaged to find these positions using computer-aided device navigation (in this case of the drill).

  Once the location of the dental implant, and even the design planning, is complete, the parts of the dental implant can be produced in a computer-assisted manner. In this way, the computer-controlled milling unit can produce models and shapes that are used to directly mill abutments and anchor parts or ultimately produce components. The superstructure may be produced directly in a similar manner, or may be modeled to a cap 80 suitable for an abutment using conventional methods. It is desirable to calculate the cap dimensions or shape in a computer-assisted manner and to produce in a computer-controlled manner, for example using a milling unit.

  In other forms, the caps can be finished and molded in-situ for individually modeled abutments. In many cases, in contrast to conventional methods where it was necessary to adapt the abutment in the field, i.e. in the patient's mouth, in the method according to the present invention, the dental technician can optimize the abutment even when it is not plugged in. Various shapes can be used. The dentist does not need to take the impression of making a cap in the patient's mouth, so there are a variety of errors, such as errors caused by the appearance of blood and saliva, and errors caused by transport from the dentist to the dental technician. Errors are avoided.

  As described above, a pushing support tool can be produced in the same manner as the cap.

  From the above, it is possible to very efficiently manufacture dental implants individually adapted to the anatomy of each patient by the method described above. High accuracy in the production process can substantially increase the quality of this type of dental implant and can substantially increase its useful life. Due to the reproducibility of the data, some conventional method steps can also be omitted.

1 is a side view of a first embodiment of a dental implant. FIG. FIG. 3 is a view corresponding to FIG. 1 of a second embodiment of a dental implant. 3 is a partial cross-sectional view of the dental implant according to FIG. 2 taken along line III-III in FIG. It is a partial cross section side view of the jig which has a plaster model. 1 is a schematic view of a fixing tool. FIG. 6 is a cross-sectional view of a third embodiment of a dental implant according to the present invention. 1 is a schematic view of a pushing support tool according to the present invention. 2 shows an abutment according to the invention with an anchor part. Figure 8b shows the abutment superstructure of Figure 8a. Fig. 8b shows a cap for the superstructure of Fig. 8b. Fig. 4 shows a further abutment according to the invention with an anchor part. Fig. 9a shows the abutment superstructure of Fig. 9a. Fig. 9b shows a cap for the superstructure of Fig. 9b. FIG. 6 is a cross-sectional view of a fourth embodiment of a dental implant according to the present invention. 1 shows a method according to the invention for producing a superstructure. 1 shows a method according to the invention for producing a superstructure. Fig. 3 shows a plurality of dental implants according to the invention in the jaw.

Explanation of symbols

DESCRIPTION OF SYMBOLS 10 ... Implant, 11 ... Abutment, 12 ... Anchor part, 13, 13 ', 13' '... Cylindrical body, 14, 14' ... Upper end part, 15 ... Pontic structure, 16 ... Polishing part, 17 ... Protection 20 ... superstructure, 21 ... fixed part, 22 ... temporary part, 30 ... opening, 40 ... jig, 41 ... holding element, 42 ... tooth model, 43, 43 '... hole, 44 ... gypsum base, 50 ... Tool, 51 ... Controller, 52 ... Hammer head, 53 ... Stem, 54 ... Hitting surface, 55 ... Rotating shaft, 56 ... Pneumatic drive, 57 ... Handle, 58 ... Distance adjuster, 59 ... Actuator, 60 ... Compressed air 61, pulse sensor, 62 ... pulse adjusting member, 63 ... pulse display, 70 ... pushing support tool, 71 ... main body, 72 ... receiving seat, 73 ... receiving opening, 80 ... cap, 82 ... internal structure of the cap , 90 ... jawbone, 91 ... gums, X, X '... central axis, Y ... abutment shaft.

Claims (41)

An anchor part (12) for fixing the dental implant (10) to the bone, and an abutment (11) for fixing the superstructure (20) connected to the anchor part (12),
In a dental implant for a patient, wherein the anchor part (12) and the abutment (11) are made of zirconia ceramic,
The anchor part (12) comprises (substantially) two substantially cylindrical bodies (13, 13 ') whose central axes (X, X') extend in the same direction, the body comprising the abutment ( 11) Dental implant characterized in that it is connected together at the upper end (14, 14 ') so as to form 11) and can be inserted into a corresponding hole in the jawbone (90).   Dental implant according to claim 1, characterized in that the abutment (11) is configured to form a bridge for at least two prosthetic elements.   The abutment (11) has a pontic structure (15) between the cylindrical bodies (13, 13 ') to form a bridge for at least three prosthetic elements. Dental implant according to claim 1 or 2, in particular according to claim 2.   2. The part (16) of the pontic structure (15) located below the connection between the cylindrical parts (13, 13 ') is polished and preferably ovoid. A dental implant according to any one of claims 1-3, in particular according to claim 3.   5. The superstructure (20) secured to the abutment (11), in particular, is melted before the dental implant (10) is inserted. The dental implant according to Item.   6. The superstructure (20) simply comprises a front lip portion (21) so that it can approach the abutment (11) behind it, in particular from above. A dental implant according to any one of the preceding claims, in particular according to claim 5.   The superstructure (20) fixed to the abutment (11), characterized in that the abutment (11) has an opening, in particular accessible from above. 6. Dental implant according to any one of claims 6, in particular according to claim 5.   The superstructure (20) comprises a temporary part (22) that protects the dental implant and can be removed after a treatment stage or replaceable with a corresponding final part of the superstructure. A dental implant according to any one of claims 1 to 7, in particular according to any one of claims 5 to 7.   Dental implant according to any one of the preceding claims, characterized in that the anchor part (12) and the abutment (11) are formed as one part.   10. The at least one support structure (30) for holding and / or forcing the cylindrical body (13, 13 ') in the hole. Dental implant.   The cylindrical body (13, 13 ′) has a rough surface formed by sandblasting or similar cutting deformation over a substantial part of the outer surface of the body before final burning / sintering of the corresponding base element. The dental implant according to claim 1, characterized in that it has a dental implant.   The dental implant (10) has a protective layer (17) that can be removed before the dental implant is positioned, at least in the region of the cylindrical body (13, 13 '), reducing the risk of infection. Dental implant according to any one of the preceding claims, characterized in that it is provided. In the drilling jig for inserting the dental implant according to any one of claims 1 to 12,
The jig (40) comprises two holes (43, 43 '), the central axis of the hole extends in the same direction, and a drill is passed through the hole in an adjusted way to form a hole in the jaw. Drilling jig characterized by at least one holding element (41) for adjusting said jig (40) on at least one tooth, which can be guided. In a pushing aid (70) for inserting a dental implant according to any one of the preceding claims,
The receiving opening (73) formed to receive at least a part of the abutment (11), and the central axis of the anchor part (12) of the abutment (11) inserted into the receiving opening (73) A body (70) comprising a seat (72) disposed on the body (71) of the push-in aid so that (X, X ') is substantially perpendicular to the seat (72). A featured push-in support tool.   Pushing aid according to claim 14, characterized in that the body (71) is made of a plastic material.   16. Pushing aid according to claim 14 or 15, characterized in that the receiving opening (73) is formed to receive the upper end (14, 14 '). In a method of manufacturing a dental implant, in particular a dental implant according to any one of claims 1-12,
Creating a three-dimensional digital image in the area of the patient's jawbone (90) and gums into which the dental implant is inserted;
-Generating a digital representation of said dental implant;
Milling the zirconium oxide-based base element, if necessary, to compensate for shrinkage;
-Sandblasting the cylindrical body of the base element;
-Burning / sintering said machined base element;
Including a method. On the bridge portion of the dental implant is provided a pontic structure between the anchor parts having an oval structure for forming a lower edge for a superstructure;
18. A method according to claim 17, characterized in that the oval structure is polished before and / or after combustion / sintering.   The method of claim 18, wherein the oval structure is dyed to correspond to the color of the superstructure.   20. A method according to any one of claims 17 to 19, characterized in that after combustion / sintering, the superstructure is melted. In a method for manufacturing and positioning a dental implant, in particular a dental implant according to any one of claims 1-12,
Generating a three-dimensional digital model of the anatomy of the region adjacent to the prospective location of the dental implant, in particular the region of teeth, jawbone and gums;
-At least partially computer-aided design of said dental implants individually adaptable to said anatomy;
-Producing said dental implant;
-Enabling and documenting the work performed;
Including a method.   The method of claim 21, comprising positioning the dental implant.   23. A method according to claim 21 or 22, characterized in that the production and / or the positioning step and / or the validation and documentation step of the dental implant are performed in a computer-aided method.   24. A method according to any one of claims 21 to 23, characterized in that a digital model is generated on the basis of conventional imaging methods of human medicine, in particular DVT.   25. The step of at least partially computer-aided design of the dental implant is performed using software in which the dental implant is digitally displayed using the digital model. The method as described in any one of.   26. In particular, as claimed in any one of claims 21 to 25, characterized in that the software gives a selection of predefined components and / or configuration quantities of the dental implant that can be individually adapted. Item 26. The method according to Item 25. Individually adapting said dental implant consisting of said superstructure (20), abutment (11), and anchor part (12), said configuration of said dental implant;
In particular, the number of prosthetic elements to accept,
And / or the diameter and / or height and / or shape of the abutment (11),
27. Method according to any one of claims 21 to 26, characterized in that it comprises the step of adapting the shape and / or height of the anchor part (12) and / or.   The step of individually adapting the dental implant consisting of the superstructure, abutment (11) and anchor part (12) comprises a shaft of a hole provided for the anchor part (12), and the superstructure 22. The step of adapting the abutment (11) and the anchor part (12) so that the angle between the horizontal axis of the body (20) can be freely selected. The method according to any one of -27.   The step of individually adapting the dental implant consisting of the superstructure (20), abutment (11) and anchor part (12) comprises the length and / or diameter and / or the superstructure (20). 29. A method according to any one of claims 21 to 28, further comprising the step of applying a color.   30. A method as claimed in any one of claims 21 to 29, wherein the at least partial computer aided design step comprises computer aided planning of the location of the dental implant.   31. A drill rail (40) is generated in a computer assisted method for positioning the dental implant during computer assisted planning of the location of the dental implant. In particular, the method according to claim 30.   32. The positioning according to any one of claims 21 to 31, characterized in that the positioning step of the dental implant is facilitated by computer-assisted intraoperative device navigation and / or computer-assisted intraoperative device activation. The method described.   The production step of the dental implant includes a step of generating a cap, in particular a computer-aided, for receiving the superstructure (20) before positioning the dental implant, the positioning the dental implant 33. The method according to any one of claims 21 to 32, wherein the method is generated prior to performing.   The step of computer aided design of the dental implant includes the step of computer aided design of an abutment (11), and the step of computer aided generation of the cap (80) comprises the internal structure (82) of the cap (80). 34), so that the cap (80) can be attached to the abutment (11), in particular according to claim 33. The method described.   35. Any of claims 21 to 34, characterized in that the calculating of the internal structure takes into account the amount of adhesive taken to secure the cap (80) to the abutment (11). 35. A method according to claim 1, in particular according to claim 33 or 34.   The computer-assisted generation of the cap (80) includes milling the cap (80) or a model of the cap (80) in a computer-controlled manner. 36. A method according to any one of claims 33 to 35, in particular.   37. A method according to any one of claims 21 to 36, wherein the positioning step of the dental implant comprises producing a pushing aid for the dental implant.   The dental implant includes an abutment (11) and an anchor part (12) connected to the abutment (11) for fixing the dental implant to the jawbone (90), and the pushing assist tool (70 23) characterized in that the step of producing comprises forming a receiving opening (73) on the push aid (70) for receiving at least a portion of the abutment (11). 37. A method according to any one of claims 37, in particular according to claim 36.   The step of producing the push-in support tool (70) includes computer-aided calculation of the receiving opening (73), the push-in support tool can be attached to the abutment (11), 39. A method according to any one of claims 21 to 38, in particular according to claim 38.   The production process of the push-in support tool (70) determines a computer-aided determination of at least one central axis (X, X ′) of the anchor part, and a seat (72) on the push-up support tool (70). Computer-aided forming, wherein the seat (72) is substantially perpendicular to the central axis (X, X ') 40. A method according to claim 1, in particular according to any one of claims 37 to 39.   41. The method of claim 21-40, wherein the production process of the push assist tool (70) includes milling the push assist tool (70) or a model of the push assist tool in a computer controlled manner. 41. A method according to any one of claims 37-40 in particular.

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